Monday, June 2, 2008

June 2, 2008 - Recovering + 10 Flights of Stairs

Well I haven't written a blog in a really long time, but I promise I have good reason. My last post announced that I would be having surgery to get a new pacemaker, and what an ordeal that turned out to be.

Kristoffer, my mom and I headed down to NYC for my surgery, scheduled for Tuesday, May 20th. The doctors planned to extract my pacemaker and the two leads (or wires that plug the device into my heart) and then implant a whole new system. When all went well, it was expected that I would be out of the hospital on the 21st.

Sadly, that was not exactly the way it all went down. My surgery took place in the cardiac catherization lab at NYU Medical Center with 3 doctors and several nurses, which is common for non-open-heart cardiac procedures. There were two problems, however. First, because I was only 19 when I got my pacemaker, doctors at Children's Hospital in Boston buried it deep in my pectoral muscle so that I wouldn't have a bump sticking out of my chest like a 90-year-old (no offense to any 90-year-olds reading this). When the NYC doctors went to remove the pacemaker I lost a significant amount of blood because the pacemaker was so deep. Problem number two was that the leads were very close to one of my veins and if the doctors had nicked the vein in trying to remove the leads, that would have lead to further bleeding that they could not have controlled because they were not in an operating room. I was told that proceeding at that point could have actually been fatal.

So, after getting the pacemaker out the doctors closed me up to recover a bit and then they scheduled a second surgery for the next day with a specialized cardiovascular surgical team. My new surgeon had done about 4,000 lead extractions before, which are much riskier and less common than pacemaker implantations or battery replacements; we were very happy to have an old pro on the job. None of us (us = me, my family, or my cardiologist) realized how tricky this process was going to be and we are very grateful that they stopped the first surgery when they realized they were in over their heads. After the first surgery didn't go too well, my father joined my mom and Kristoffer in NYC. They were all an amazing support to me, but it is clear to me now how scary it must have been for them when the doctor explained what went wrong.

Day 2 brought surgery #2, in the operating room, with a lot of doctors and nurses supporting my primary surgeon. For the first surgery I was heavily sedated and knocked out for the whole thing, but for the second surgery I was under general anesthesia and was not breathing on my own (that means I was on a ventilator) so that the surgeon had ultimate control over what was happening. When they began the procedure, they realized that I had lost too much blood the first time around for them to continue and so first they gave me a blood transfusion. Then they successfully removed the old leads without nicking my vein, and implanted two new leads and a new pacemaker. The new leads are positioned differently than the old ones to avoid some of the problems I had with them, and the pacemaker is not buried as deeply in my muscle as the first one was. This means that the next time I need a new battery (8-10 years, give or take a few) the procedure should not be as complicated. It also means that I do have a slight bump on my chest - so while I don't exactly look 90 the site is not as flat as it has been the last 8 years. The surgeon was not sure that he was going to be able to keep the pacemaker on the left side of my body and there was a chance he would have had to open my right side and implant the new pacemaker there, which would have made my recovery much more difficult. The very good news is that he was able to keep the new one on the left side and I am extremely grateful to not have symmetrical incisions.

Once the surgery was done, it took two more days for me to have the strength to be discharged. The first time I got out of bed to try and walk around I quickly fainted - not because of my heart but because I hadn't eaten or had anything to drink in over 48 hours! I also had significant pain and my blood count was kind of funny so they had to make sure I wasn't bleeding internally before they discharged me. Finally, on the evening of Friday, May 23rd at 5:30pm they dismissed me to "enjoy" my Memorial Day Weekend. My parents, Kristoffer, and I took a taxi uptown to my friend Jean's, our "home base" in NYC, for the night and when we arrived we encountered a new problem. For the first time in 5 years, all 3 of the elevators in her building were broken. No joke. All of them. Broken.

We went to a diner for dinner, stocked up on some post-op supplies at the nearest drug store and hoped that the elevators would be fixed quickly...but our hopes were to no avail. I was tired, in severe pain, and wanted to go back to the hospital where there was a wheelchair! After debating about getting a hotel (where? how much? what a hassle!) or leaving instantly to drive back to Massachusetts (in Memorial Day Weekend Friday night traffic?! no thanks!), the only practical option we had was to walk up 10 flights of stairs to Jean's apartment. After 2 heart surgeries, 1 blood transfusion, and 2 hours out of the hospital, that is exactly what I did. Kristoffer sort of held me from behind so that I didn't fall and we just took it very slow, but we did climb up those damn stairs.

At 5:45 in the morning we woke up to drive back to my parents' house in Plymouth and, sure enough, the elevators were still not working! So we had to walk back down the freakin' stairs! I kid you not. My mom and I decided that even an author or screenwriter wouldn't be so mean as to write such a story! Once we got down the stairs, though, we had an easy ride home and I have since been recovering. Kristoffer was able to stay two more days before heading back to Nairobi and my parents have been seriously pampering since he left.

Currently, I am no longer medicating. The doctors really wanted me to deal with my pain and not rely on drugs so much - so I weaned down to only taking pills before bed and now to not taking them at all. The only times I have serious pain now are at night when I am really tired - it is mostly aches and constant soreness. I have increased mobility but can't lift my left arm for about 4 more weeks. I don't sleep through the night, but wake up a lot to try and get comfortable, and I do get tired very easily so I take a lot of small naps. I am eating well though and my parents walk me and their dog regularly for exercise. I will see my surgeon and cardiologist next Monday and will hope for the "all clear" to travel back to Kenya.

Kristoffer and I had been looking to move out of our apartment for a little while and before my surgeries he had found both a house and an apartment for me to check out when I got back. Well, needless to say I haven't gotten back yet and Kristoffer had to make a decision without me. He chose the house and moved into it this weekend. He brought me a video of the house and it looks perfect for us - only a few years old, clean, bright, and pretty big. It is on a compound with 9 other houses in the very best and most desired neighborhood among UN staff, and we even know a couple who live there already. So, including my consultancy at UNICEF, I have a lot to look forward to when I get back to Nairobi!

Hopefully when I get back to my real life and my husband, I will get back to updating the blog on a weekly basis at least. Thank you to everyone who has corresponded with me, sent flowers, visited, emailed and kept me in their thoughts and prayers. Believe me when I say that every little bit helps!

Sorry to hear the surprisingly bad luck w/the elevators. I was back from Peru by then and wish I knew. We'd have been more than happy to let you have our home in Bklyn instead (and moved to Jean's or a friend's). We're just one flight up in our brownstone. Glad the ordeal is over!